A "Revolutionary" New Treatment Could Allow Kidney Transplants From Any Donor

DAVID NIELD

11 MAR 2016

The search to find a compatible kidney donor is often a long and agonising one - a complex series of biological matches need to be met to reduce the risk of the new organ being rejected, which means most kidney transplants have to come from blood relatives. Now a pioneering new technique is being tested that could allow those needing a transplant to receive a kidney from any donor.

Experts are calling the new procedure revolutionary, reports The New York Times, and it could have a huge impact on the waiting times for a suitable kidney. It works by altering a patient's immune system - essentially rebooting its network of antibodies to make them less likely to reject a new organ. It's not yet clear why, but the regenerated antibodies that appear after the originals have been filtered out are much more amenable to receiving a new kidney through a transplant.

The process, known as desensitisation, has been used by doctors on a small scale for several years, but the new report published this week is the first to take a broad look at how effective it really is.

Based on data from over 2,000 patients at 22 health clinics, 76.5 percent of the desensitised patients who were given an 'incompatible' kidney were still living after eight years – a more positive result than the 62.9 percent of the control group who were still on the waiting list or who received a deceased donor kidney rather than a living one.

It might be some time before the practice is widely used: it involves medications not officially approved for the purpose, and costs around US$30,000 to carry out. Even the title of the new report, published in the New England Journal of Medicine, asks whether this type of transplant is "worth the risk" for patients.

But with nearly one in three of those needing a transplant being considered difficult to find a match for, and 100,000 people on the waiting list in the US alone, this might be the only option for some patients.

The alternative for those hard-to-match patients is spending hours on a dialysis machine just to stay alive. The New York Timescites the case of 56-year-old lawyer Chris Smith, who was freed from the rigours of dialysis thanks to a living donor and the desensitisation process.

"You don't need a compatible living donor to make a transplant happen today, you just need a living donor," said lead researcher Dorry Segev of Johns Hopkins University, while admitting that "desensitisation is still not for every transplant centre", and other options should also be considered.

Segev says the same process could eventually be used in other living organ transplants, such as those for the liver and the lungs. In the meantime, it represents a pricey ray of hope for those waiting for a kidney transplant, one that's backed up by some promising new figures.